Ambulance patients waiting up to 36 hours to be admitted at hospitals,inquiry hears

NSW hospital patients are waiting up to 36 hours to be admitted through emergency departments,where increasing ambulance ramping and overcrowding are resulting in inadequate and unsafe care.

The worsening reality of workload and staffing in the state’s hospitals was canvassed in a parliamentary inquiry on Wednesday,which heard health sector strains were a global phenomenon that had been growing for decades.

Ambulance ramping in NSW hospitals is “at its worst”,an inquiry has heard.

Ambulance ramping in NSW hospitals is “at its worst”,an inquiry has heard.Janie Barrett

Patients on stretchers for more than 14 hours and others regularly treated in corridors was leading to detrimental health outcomes and keeping ambulance crews from responding to new cases,emergency health specialists said.

President of the Australasian College for Emergency Medicine president Dr Clare Skinner told the inquiry in every shift it was now normal that hospitals would experience difficulty offloading ambulances and instead treat patients in corridors and waiting rooms.

“That means it’s public,it’s not dignified,and it also seriously limits your ability to perform a proper medical examination ... it’s just not adequate,and it’s not safe,” she said.

“It’s like working with a conveyor belt full of things you can’t get to fast enough,but what’s on the conveyor belt is human distress and suffering.”

At the inquiry (from left) emergency medicine physicians Dr Pramod Chandru and Dr James Tadros,and Dr Setthy Ung. district chairman,South Western Sydney Local Health District medical staff executive council.

At the inquiry (from left) emergency medicine physicians Dr Pramod Chandru and Dr James Tadros,and Dr Setthy Ung. district chairman,South Western Sydney Local Health District medical staff executive council.Renee Nowytarger

While she acknowledged “tremendous” and necessary health infrastructure spending by the government in recent years,she said there had not been concurrent investment in the staff needed to service hospitals at every level.

The upper house inquiry was established in July to examine the rising incidence of ambulance ramping – where paramedics are stuck outside hospitals waiting for hours to offload patients.

The Labor-led inquiry will hear from a range of healthcare professionals about the pressures facing emergency departments and the impact on treatment times.

It heard patients had a 10 per cent greater chance of dying within seven days of admission after experiencing delays in admission,while children and adolescents with mental health problems have the fastest growing trajectory of emergency department presentations.

Vice president of the Australian Paramedics Association Scott Beaton also gave evidence on Wednesday,telling the inquiry ambulance ramping was currently “at its worst”.

“Although it was bad in the early 2000s ... it’s certainly back with a vengeance across the whole of NSW. Whereas previously it seems to be metropolitan-based,it’s now the whole of the state that seems to be being affected.”

He said it was positive to see government commitments to increase the number of ambulances and paramedics,“but it doesn’t help when they get to the destination with the patients that are then all stuck for hours on end”.

Chief executive of the Council of Ambulance Authorities (CAA) David Waters told the inquiry transfer of care delays,or ramping,was a sign of a health system under systemic strain.

The council represents 11 statutory ambulance services across Australia,New Zealand and Papua New Guinea,accounting for 4.6 million patients annually.

Waters said 30 minutes was considered an acceptable amount of time to move a patient from an ambulance to a hospital bed. Anything longer is considered a delay.

“Over the last few years CAA members have reported that their transfer of care delays are increasing,and it’s not uncommon to see periods of four to six hours of patients remaining on the ambulance stretcher and in some instances ... up to 12 to 14 hours,” he said.

Data from the Bureau of Health Information’s quarterly report last month showed patients seeking treatments at NSW hospitals faced record waits when arriving at hospital by ambulance;more than a quarter of patients spent at least 30 minutes parked outside or waiting in corridors before they were able to enter emergency.

More than 76,000 people – or one in 10 attendees – left the department without completing their treatment between April and June this year,the highest quarterly figure on record.

The inquiry will hear from surgeons,health sector unions and South Western Sydney Local Health District among other witnesses on Wednesday afternoon.

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Lucy Cormack is a journalist for The Sydney Morning Herald and The Age,based in Dubai.

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